Stress Echocardiography in the Era of Fractional Flow Reserve

Standardized hyperemic stress for fractional flow reserve.

Fractional Flow Reserve

Traditionally, coronary artery disease was assessed using coronary angiographic guidance. Significant lesions were determined by the coronary angiographer. However, interobserver variability showed a significant limitation of interpretation of coronary angiography. Stent deployment and apposition were also evaluated based on angiographic appearance only. Risk factors for stent thrombosis and in...

Coronary Flow Velocity Reserve during Dobutamine Stress Echocardiography

BACKGROUND A coronary flow velocity reserve (CFVR)≥2 is adequate to infer a favorable prognosis or the absence of significant coronary artery disease. OBJECTIVE To identify parameters which are relevant to obtain CFVR (adequate or inadequate) in the left anterior descending coronary artery (LAD) during dobutamine stress echocardiography (DSE). METHODS 100 patients referred for detection of ...

Hybrid Instantaneous Wave-Free Ratio–Fractional Flow Reserve versus Fractional Flow Reserve in the Real World

BACKGROUND The instantaneous wave-free ratio (iFR) is a novel method to assess the ischemic potential of coronary artery stenoses. Clinical trial data have shown that iFR has acceptable diagnostic agreement with fractional flow reserve (FFR), the reference standard for the functional assessment of coronary stenoses. This study compares iFR measurements with FFR measurements in a real world, sin...

Comparison of Fractional Flow Reserve Assessment With Demand Stress Myocardial Contrast Echocardiography in Angiographically Intermediate Coronary Stenoses.

BACKGROUND Real-time myocardial contrast echocardiography (RTMCE) directly measures capillary flow (CBF), which in turn is a major regulator of coronary flow and resistance during demand or hyperemic stress. Although fractional flow reserve (FFR) was developed to assess the physiological relevance of an epicardial stenosis, it assumes maximal microvascular vasodilation and minimal resistance du...